TY - JOUR
T1 - Medial versus lateral transcondylar screw placement for canine humeral intracondylar fissures
T2 - A randomized clinical trial
AU - Carwardine, Darren
AU - Mather, Alastair
AU - Schofield, Imogen
AU - Langley-Hobbs, Sorrel
AU - Carbonell-Buj, Elena
AU - Belch, Alex
AU - Barthelemy, Nicolas
AU - Parsons, Kevin
N1 - Publisher Copyright:
© 2023 American College of Veterinary Surgeons.
PY - 2023/7/12
Y1 - 2023/7/12
N2 - Objective: To determine the influence of screw direction on complications following transcondylar screw placement for the treatment of canine humeral intracondylar fissures (HIFs). Study design: Equivalence, parallel group, randomized clinical trial. Sample population: Fifty-two client owned dogs (73 elbows). Methods: Transcondylar screw placement was randomized to either a medial or lateral approach. The primary outcome was the incidence of postoperative complications.Results: There were 37 cases in the lateral approach group and 36 cases in the medial approach group. There was a significantly greater proportion of postoperative complications following placement of transcondylar screws from a lateral to medial direction (p =.001). There were seven cases with complications (19%) in the medial approach group versus 23 cases with complications (62%) in the lateral approach group. The majority of complications were seromas (n = 13) and surgical site infections (n = 16) with 4 complications requiring further surgery. Implant area moment of inertia (AMI), normalized to bodyweight, was lower in dogs with a major complication (p =.037). Conclusion: Transcondylar screws placed from lateral to medial for canine HIFs had a greater proportion of postoperative complications in this randomized clinical trial design. Implants with a lower AMI, relative to bodyweight, were more likely to lead to major complications. Clinical significance: We recommend placing transcondylar screws from medial to lateral for canine HIFs to reduce the risk of postoperative complications. Relatively small diameter implants had an increased risk of major complications.
AB - Objective: To determine the influence of screw direction on complications following transcondylar screw placement for the treatment of canine humeral intracondylar fissures (HIFs). Study design: Equivalence, parallel group, randomized clinical trial. Sample population: Fifty-two client owned dogs (73 elbows). Methods: Transcondylar screw placement was randomized to either a medial or lateral approach. The primary outcome was the incidence of postoperative complications.Results: There were 37 cases in the lateral approach group and 36 cases in the medial approach group. There was a significantly greater proportion of postoperative complications following placement of transcondylar screws from a lateral to medial direction (p =.001). There were seven cases with complications (19%) in the medial approach group versus 23 cases with complications (62%) in the lateral approach group. The majority of complications were seromas (n = 13) and surgical site infections (n = 16) with 4 complications requiring further surgery. Implant area moment of inertia (AMI), normalized to bodyweight, was lower in dogs with a major complication (p =.037). Conclusion: Transcondylar screws placed from lateral to medial for canine HIFs had a greater proportion of postoperative complications in this randomized clinical trial design. Implants with a lower AMI, relative to bodyweight, were more likely to lead to major complications. Clinical significance: We recommend placing transcondylar screws from medial to lateral for canine HIFs to reduce the risk of postoperative complications. Relatively small diameter implants had an increased risk of major complications.
UR - http://www.scopus.com/inward/record.url?scp=85164710606&partnerID=8YFLogxK
U2 - 10.1111/vsu.13993
DO - 10.1111/vsu.13993
M3 - Article (Academic Journal)
C2 - 37435744
AN - SCOPUS:85164710606
SN - 0161-3499
JO - Veterinary Surgery
JF - Veterinary Surgery
ER -